NPI Record

No.

Field Name

Field Value

Field Definition 1

1

NPI

1033533542

The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.

2

Entity Type Code

2

Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).

3

Employer Identification Number EIN

The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.

4

Provider Organization Name Legal Business Name

THE THREE COPTIC BROTHERS CORP.

The name of the organization provider. If the provider is an organization, this is the legal business name.

5

Provider First Line Business Practice Location Address

2297 CONEY ISLAND AVE

The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

6

Provider Business Practice Location Address City Name

BROOKLYN

The city name in the location address of the provider being identified.

7

Provider Business Practice Location Address State Name

NY

The State code in the location of the provider
being identified.

8

Provider Business Practice Location Address Postal Code

112233337

The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.

The country code in the location address of the provider being identified.

10

Provider Business Practice Location Address Telephone Number

7186454500

The telephone number associated with the location address of the provider being identified.

11

Provider Business Practice Location Address Fax Number

7186454505

The fax number associated with the location
address of the provider being identified.

12

Provider Enumeration Date

2/5/2014

The date the provider was assigned a unique identifier (assigned an NPI).

13

Last Update Date

2/5/2014

The date that a record was last updated or changed.

14

Authorized Official Last Name

NASEF

The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.

15

Authorized Official First Name

SALEH

The first name of the authorized official.

16

Authorized Official Title or Position

DIRECTOR

The title or position of the authorized official.

17

Authorized Official Telephone Number

7186454500

The 10-position telephone number of the authorized official.

18

Healthcare Provider Taxonomy Code 1

261QA0600X

Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.